Americans to Health Officials: Fix Health System Now

August 17, 2006 ( - Those responding to a recent survey on the state of the US health care system had an unmistakable message: The system is broken, it costs too much and it needs to be fixed immediately.

That was a key conclusion emerging from a new survey taken for The Commonwealth Fund, which laid out in detailed terms the multitude of problems respondents were having with accessing and paying for their needed medical care.

Another key bottom line in the Commonwealth survey report is that it is not just lower-income Americans who fret about being able to pay for their medical care. Health affordability is now a concern at even higher-income levels. For example, one-third of adults with annual incomes between $50,000 and $74,999 reported serious problems in finding the money for their care.


  • more than half of all households are experiencing stress when paying for medical care.
  • a similarly high proportion of middle- and lower-income adults reported difficulties paying for health insurance.
  • among these middle- and lower-income groups, more than one of four described cost concerns as “very serious.”
  • half of middle-income ($35,000 to $49,999 annually) and lower-income (less than $35,000 annually) families said they have had serious problems paying for care in the past two years.

Commented the Commonwealth Fund researchers: “Across income groups and regions of the country, there was resounding agreement that ensuring reliable health insurance and controlling rising costs are the most pressing health policy issues for the President and Congress to tackle.”

Spreading Health Data

The survey also found that respondents heavily backed the notion that health care quality and cost data should be widely available and that quality and efficiency should help drive the size of doctor and hospital payments. Specifically:

  • nearly all adults (95%) feel it is important to have information about the quality of care provided by different doctors or hospitals, with three-quarters (77%) saying this is very important.
  • a strong majority (91%) also thinks it is very or somewhat important to have information about the costs before getting care.
  • more than four of five Americans (87%) think it is important for insurance companies to identify and reward doctors and hospitals for excellence

Respondents also used the Commonwealth survey to express their frustration about getting timely care and spending time on paperwork and having disputes related to medical bills and insurance. For example:

  • Timely access is a broad concern. In the past two years, two of five adults (39%) reported serious problems getting prompt appointments to see a doctor when sick or in need of medical attention without going to the emergency room.
  • One-third of Americans (36%) have trouble finding information on care for a very ill or aging family member.

‘Transformative Change’

“Health care costs are escalating and the numbers who are uninsured or underinsured are growing ever greater,” the research report asserted. “Patients and families want transformative change. Listening to the voices of patients about their care experiences provides a prescription for what is most ailing in our current system. Patients want a genuine system of health care – one where care is coordinated, no one falls through the cracks, and every one is secure in the knowledge that the best of American medicine will be there for them. It is a clarion call that should not go unheard.”

The telephone survey covered a representative sample of 1,023 adults.